Paracetamol-induced cholestatic and granulomatous liver injuries.

Lindgren, A; Aldenborg, F; Norkrans, G; Olaison, L; Olsson, R · J Intern Med · 1997

case_report · Level V

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Abstract

OBJECTIVE: To describe uncommon (previously unreported) types of adverse liver reactions to paracetamol. DESIGN: In addition to describing patients, with uncommon types of liver reactions to paracetamol, admitted to our hospitals, we surveyed all the liver reactions to paracetamol reported to the Swedish Adverse Drug Reactions Advisory Committee from 1973 to 1993. SETTING: The Swedish population of 8 million inhabitants. MEASUREMENT: Extensive medical evaluation. RESULTS: We found one case with a cholestatic liver reaction and one with granulomatous hepatitis. The reactions were probably idiosyncratic and took several months to disappear. CONCLUSION: In addition to the well-known dose-related toxic liver damage paracetamol may rarely cause non-dose-related severe, prolonged cholestasis or granulomatous hepatitis with cirrhosis.

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